基于倾向性评分匹配法的老年男性腹型肥胖与血清性激素水平的相关性分析  

Propensity score-matched analysis of association between serum sex hormone levels and abdominal obesity in elderly men

作　　者：阴大伟[1] 鲁晓春[1] 惠海鹏[1] 刘翠娥[2] 梁辉[2] 朱婷婷[2] Yin Dawei;Lu Xiaochun;Hui Haipeng;Liu Cuie;Liang Hui;Zhu Tingting(Department of Cardiology,Chinese PLA General Hospital No.2 Medical Center,National Clinical Research Center for Geriatric Diseases,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心心血管内科国家老年疾病临床医学研究中心,北京100853 [2]解放军总医院第二医学中心急诊科,北京100853

出　　处：《中华老年心脑血管病杂志》2021年第7期704-707,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：解放军总医院第二医学中心应用基础研究项目(ZXD2007)。

摘　　要：目的评估老年男性腹型肥胖与血清性激素水平的相关性。方法选取2015年1月~2016年12月北京市海淀区万寿路社区老年男性776例,年龄60~94(71.00±5.24)岁。以腰高比≥0.5为标准分为腹型肥胖组251例和非腹型肥胖组525例。对2组进行1︰1倾向性评分匹配,匹配后腹型肥胖组204例,非腹型肥胖组204例。收集一般临床资料及血清性激素指标等。匹配后数据采用logistic回归与限制性立方样条(RCS)法进行分析。结果匹配前腹型肥胖组年龄、高血压、当前吸烟、当前饮酒、收缩压、舒张压、空腹血糖、TG、腰高比较非腹型肥胖组明显升高,HDL-C、总睾酮和性激素结合球蛋白(SHBG)水平较非腹型肥胖组明显降低(P<0.05,P<0.01)。匹配后腹型肥胖组腰高比较非腹型肥胖组明显升高,总睾酮和SHBG水平较非腹型肥胖组明显降低(P<0.05,P<0.01)。多因素logistic回归分析显示,血清性激素指标中,仅SHBG是老年男性腹型肥胖的独立危险因素(OR=0.993,95%CI:0.989~0.998,P=0.003)。RCS分析表明,老年男性血清SHBG的连续变化与腹型肥胖风险的关联呈非线性负相关(r=-0.372,P<0.01)。结论老年男性血清SHBG水平与腹型肥胖风险相关。Objective To evaluate the association between serum sex hormone levels and abdominal obesity in elderly men.Methods Seven hundred and seventy-six elderly men in Beijing Wanshoulu Community enrolled from January 2015 to December 2016 were divided into abdominal obesity group(n=251)and abdominal obesity-free group(n=525)according to their waist/height ratio.Then 408 elderly men were further divided into abdominal obesity group(n=204)and abdominal obesity-free group(n=204)according to the 1︰1 propensity score matching.Their general clinical data and serum sex hormone-binding globulin(SHBG)level were recorded.The matched data were analyzed by multivariate logistic regression analysis and restricted cubic spline(RCS)analysis,respectively.Results The age was significantly older,the incidence of hypertension,ratio of current smoking and alcohol consumption,SBP,DBP,serum levels of fasting blood glucose and TG,waist/height ratio were significantly higher while the serum levels of HDL-C,total testosterone and SHBG were significantly lower in abdominal obesity group than in abdominal obesity-free group before matching(P<0.05,P<0.01).The waist/height ratio was significantly higher while the serum levels of total testosterone and SHBG were significantly lower in abdominal obesity group than in abdominal obesity-free group after matching(P<0.05,P<0.01).Multivariate logistic regression analysis showed that serum SHBG level was an independent risk factor for abdominal obesity in elderly men(OR=0.993,95%CI:0.989-0.998,P=0.003).RCS analysis displayed that serum SHBG level was nonlinearly associated with the risk of abdominal obesity in elderly men(r=-0.372,P<0.01).Conclusion Serum SHBG level is associated with the risk of abdominal obesity in elderly men.

关 键 词：肥胖 腹部 性激素结合球蛋白 高血压 吸烟 饮酒 血糖 

分 类 号：R589.2[医药卫生—内分泌]